Download A guidebook on nutritional care and support for people living

A guidebook on nutritional care and
support for people living with HIV
and AIDS in Eritrea
Guide for home based care service providers and
people living with HIV and AIDS and their families
A guidebook on nutritional care and
support for people living with HIV
and AIDS in Eritrea
Guide for home based care service providers, and
people living with HIV and AIDS and their families
© 2005, Ministry of Health of the State of Eritrea, World Food Programme
Eritrea, UNAIDS Eritrea
This material may be copied, translated, and disseminated (as long as no profit
is derived from and reference is given to this book).
This booklet was compiled by Iskinder Berhane and Piet Vochten with the
assistance of the NATCO (National HIV/AIDS/STI and Tuberculosis Control
Division) and the Nutrition Unit of the Ministry of Health of Eritrea; WFP
Eritrea; UNAIDS Eritrea; WHO Eritrea; FAO Eritrea; The Eritrean Association
of People Living With HIV and AIDS (BIDHO); The Evangelical Church of
Eritrea’s HIV and AIDS Programme; The Orthodox Church of Eritrea HIV and
AIDS Programme, The Eritrean Mufti HIV and AIDS Programme, The Eritrean
Catholic Secretariat (ErCS) HIV and AIDS Programme; and received funding
through the UNAIDS Programme Acceleration Fund (PAF).
Comments and observations, including possible other beneficial recipes and
care practices can be sent to the UNAIDS and WFP offices in Asmara, where
they will be collected and used for an update of this booklet in the future.
UNAIDS, No. 5 Warsay Street, Asmara, Eritrea, email: [email protected]
http://eritrea.unaids.org
WFP, Saba Building, Warsay Street, Asmara, Eritrea
www.wfp.org
Foreword
Eritrea is probably the most blessed among the sub-Saharan
African countries with an overall HIV prevalence that appears to
be stabilizing at 2.4% (2003 round of HIV sentinel Surveillance,
Ministry of Health). However, infection levels vary considerably,
highlighting a need to intensify and to refine the focus of
prevention efforts. Prevalence reached 7.2% along the southern
coastal strip, and was more than three times as high in urban
than in rural areas.
Home-based care and socio-economic support services are now
reaching thousands of families. Access to antiretroviral therapy
(ARV) will be initiated in 2005. Therefore, we welcome this
initiative to produce a guidebook on nutrition for people living
with HIV and AIDS in Eritrea.
Unfortunately, Eritrea is a poor country with limited natural
resources. That is why we highly appreciate that the traditional
food of the different groups of the Eritrean people were
incorporated in the guide book, and that cleat attention was
given to the economic capacity of the poorest among those
affected by HIV and AIDS. It is important to note that good
nutrition does not have to be expensive as is shown by many of
the recipes proposed in this guidebook.
Food, appropriate nutrition and proper care are indeed crucial
factors in prolonging and improving the quality of life of people
living with HIV and AIDS.
We encourage all people affected by HIV and AIDS as well as
service providers, from home-based care volunteers to all
categories of health workers, to make good use of this
guidebook and make it available to all those that might need it.
iii
iv
Contents
Contents
Acronyms
Introduction
Who is this guide for?
How can this guide be used?
Chapter 1 – Nutrition for people living with HIV and AIDS
v
ix
xi
xi
xi
1
1.1 Why is malnutrition more common among people
3
living with HIV and AIDS?
1.2 The importance of healthy food for people living with
3
HIV and AIDS
1.3 Guidelines for healthy food
4
1.4 What to consider when selecting food on a daily basis
9
1.5 Names of common food products in Eritrean languages
11
Mini-poster: What to eat and do to help the body fight HIV and AIDS 13
Chapter 2 – Common nutritional problems related to
symptoms and illnesses associated with HIV
and AIDS and some dietary advice
15
2.1 Tuberculosis
2.2 Herpes zoster
2.3 Sore throat
2.4 Sore mouth
2.5 Thrush/Candida
2.6 Haemorrhoids /constipation
2.7 Anaemia
2.8 Loss of appetite
2.9 Diarrhoea
2.10 Weight loss
2.11 Nausea and vomiting
2.12 Fever
2.13 Headache
18
18
20
20
21
23
23
24
24
26
28
29
29
v
2.14 Colds and influenza (flu)
2.15 Cough
Mini-poster: Common illnesses associated with HIV and AIDS
and some dietary advice
30
30
31
Chapter 3 – Food recommended to better fight HIV and AIDS 33
3.1 Foods rich in selenium
3.2 Foods rich in zinc
3.3 Foods rich in vitamin A/beta-carotene
3.4 Foods rich in vitamin B12
3.5 Foods rich in vitamin C
3.6 Garlic
3.7 Cabbage
Mini-poster: Healthy food
35
36
38
38
39
40
40
41
Chapter 4 – Safe hygienic practices when dealing with food
43
Mini-poster: Safe hygienic practises
49
Chapter 5 – Herbal and heat treatments
51
5.1 Keeping the body temperature warm to better fight 53
HIV and AIDS
5.2 Herbs, their benefits and how to use them
54
5.3 Common Eritrean herbs
58
Chapter 6 – Eritrean recipes for foods and drinks
61
6.1
6.2
6.3
6.4
63
70
72
77
Common dishes
Soups
Teas and drinks
Snacks and other useful recipes
Endnotes
vi
81
Annexes
83
Annex 1. Cross reference tables of Eritrean recipes and their
85
respective usefulness
Annex 2. Ways to sprout grains for eating
91
93
Annex 3. Recommended Daily Allowance for an adult
person or child older than four years living with
HIV and AIDS
Annex 4. Suggested vitamin and mineral supplements for
94
people living with HIV and AIDS
Annex 5. Foods rich in selenium
95
Annex 6. Possible adverse effects of excessive intake of
96
nutrient supplements
Annex 7. Role and source of selected micronutrients
97
Annex 8. Form to monitor food intake over one week
99
Annex 9. Form to monitor weight changes over time
100
Annex 10. Bibliography and sources
103
Annex 11. Glossary
105
vii
viii
Acronyms
AIDS
Acquired Immune Deficiency Syndrome
ARV
Antiretroviral
CSB
Corn Soya Blend
DMK
Dura Milk Kebkebe
FANTA
Food and Nutrition Technical Assistance Project
FAO
Food and Agriculture Organization
HIV
Human Immunodeficiency Virus
MoH
Ministry of Health
RDA
Recommended Daily Allowance
UNAIDS Joint United Nations Programme on HIV and AIDS
UNICEF
United Nations Children’s Fund
USAID
United States Agency for International Development
WFP
World Food Programme
WHO
World Health Organization
ix
x
Introduction
HIV and AIDS weaken a person’s immune system and increase
the chance of contracting opportunistic infections, as well as
worsening their severity. These opportunistic infections may
cause symptoms such as loss of appetite, fever and diarrhoea
that, in turn, reduce food intake, nutrient utilisation and increase
the requirements for nutrients. As a result, the person becomes
malnourished, loses weight and is weakened, which can speed up
the progression from HIV to full blown AIDS.
The bodies of people living with HIV and AIDS require more
nutrients (carbohydrates, protein, fats, vitamins and minerals) in
order to fight infections and slow down the advancement of the
HIV infection.
Who is this guide intended for?
This guidebook attempts to address a number of key issues
related to nutrition for people living with HIV and AIDS. It is
primarily intended for use by:
• HIV and AIDS home-based care providers
• People living with HIV and AIDS
• The family members of people living with HIV and AIDS.
It may also serve as a reference for other interested individuals
interacting with people living with HIV and AIDS and their
families. At the same time the advice given on healthy eating
and food, handling practices can easily help and direct healthy
eating for most people in Eritrea.
How can this guide be used?
This guidebook highlights thematic issues related to HIV and
AIDS and nutrition. It provides a general approach to the
diverse conditions existing in Eritrea. It is best read as a whole,
but each chapter can also be read separately. The annexes
xi
include recipes of a number of dishes, foods and drinks that can
be beneficial to people living with HIV and AIDS. The
recommendations given in this booklet will need to be adapted
to the person who will be eating the food, also keeping in mind
the local context where they live. Whenever reference is made
to a recipe that is mentioned in the annexes, it will be written in
the following way: ginger tea.
Page 13 and 14 have an overview of photographs of less
common or region-specific Eritrean food ingredients and list
their local names in the nine Eritrean languages. Photographs of
useful herbs are given on page 58 and 59.
This guidebook consists of five chapters plus annexes:
Chapter One – Nutrition for People Living with HIV and
AIDS –describes the causes of malnutrition, the importance of
healthy food for people living with HIV and AIDS and gives
some guidelines for healthy food consumption.
Chapter Two – Common Nutritional Problems Related to
Symptoms and Illnesses Associated with HIV and AIDS –
provides dietary advice for people who are coping with HIV and
AIDS-related symptoms and illnesses.
Chapter Three – Foods Recommended to Better Fight HIV
and AIDS – provides basic information on the selection of
important nutrients from cheap and locally available food
products.
Chapter Four – Safe Hygienic Practices – provides information
on the proper hygienic practices for handling and preparing food.
Chapter Five – Herbal and Heat Treatment – provides
information on the use of herbs and food as alternative ways to
manage HIV and AIDS related symptoms and illnesses. It also
gives a number of techniques for keeping the body temperature
high enough in order to fight better HIV and AIDS.
xii
Chapter Six – Eritrean recipes for foods and drinks – provides
recipes for common dishes, soups and drinks that can be
prepared using cheap and locally available ingredients.
The Annexes provide additional information on nutrition and
food preparation. They also include two forms that can be used
for monitoring the daily food intake and weight change.
An overview of the different measurements used in this
guidebook is given below:
Measurement
1 teaspoon
Weight
(gram)
Volume
Remarks
(millimetre)
5
5
1 tablespoon
15
15
3 teaspoon
1 fengal
50
50
10 teaspoon
1 chelfa
100
100
refers to the medium
sized chelfa used for
stews (sauce).
1 chelfa = 2 fengal
1 cup
250
250
1 cup = 2½ chelfa or
5 fengal
1 injera
300
average weight of
injera
1 bread
100
a small bread roll
(the cost of the bread in
2004 was 0.35 nakfa)
1 melekia
25
1 litre (l)
1000
1000
1 kilogram (kg)
1000
1000
700
700
1 melelik
1 litre = 4 cups or
10 chelfa
1 melelik = 2 4/5 cups
xiii
xiv
CHAPTER ONE
Nutrition for people living with HIV
and AIDS
Good nutrition cannot cure AIDS or prevent HIV infection, but
it can help to maintain and improve the nutritional status of a
person with HIV and AIDS and delay the progression from HIV
to AIDS.
2
1. Nutrition for people living with HIV
and AIDS
1.1 Why is malnutrition more common among
people living with HIV and AIDS?
• Loss of appetite – when not eating enough, the body does not
gain weight.
• Diarrhoea – makes the body lose minerals and water
(dehydration).
• Fever – makes the body reduce the utilisation of food.
• Depression (e.g., caused by loneliness, isolation, or
discrimination) – makes a person lose his or her appetite.
• Nausea and frequent vomiting – reduces a person’s appetite
and results in poor utilisation of food by the body.
• Sore mouth (thrush) – results in poor food intake and loss of
appetite.
HIV-positive people taking antiretroviral (ARV) medicines
should always follow the instructions of their doctor, since
taking ARVs incorrectly might result in some of the symptoms
mentioned above.
Many of the diseases and symptoms described above increase
the need for food and its nutrients. Therefore, for a person living
with HIV AND AIDS, malnutrition is both a cause and an effect
of weight loss and worsening health status.
1.2 The importance of healthy food for people living
with HIV and AIDS
• Helps to maintain health and quality of life.
• Strengthens the immune system and reduces vulnerability to
opportunistic infections such as tuberculosis and other
bacterial and fungal infections.
3
• Delays progression from HIV to AIDS.
• Provides the body with the essential nutrients for tissue
growth and repair of the body.
• Reduces the severity of infections, contributes to weight gain,
and prevents malnutrition.
• Improves the effectiveness of drug treatments.
1.3 Guidelines for healthy food
Food is made up of nutrients such as carbohydrates, proteins,
fats, vitamins and minerals. The body cannot work properly if
one or more nutrients are missing. A healthy, nutritious diet is
composed of a variety of foods, which provide the essential food
components and nutrients on a daily basis.
No single food contains all the necessary nutrients in the right
quantities and combinations. A mix of different foods can
supply the nutrients the body needs. Therefore, one should:
a. Eat staples with every meal
Staples such as injera, porridge, teheni, wheat, rice, barley,
sorghum, millet, maize and teff (used to make injera) provide
the body with energy. They are relatively cheap and easy to find.
Eritrean Staples
Injera with tsebhi (stew)
Porridge
b. Eat sufficient fibre and starchy foods
Fibre helps to prevent constipation and is good for the
functioning of the gut and intestines. Cereals, pulses (also called
legumes), vegetables and fruits provide fibre while also
4
supplying the body with energy, proteins, vitamins and minerals.
Animal products contain no fibre.
The skins of cereals and pulses contain fibre as well as vitamins.
Therefore, cereals and pulses should be eaten with their skin;
when eaten as flour, it should be whole-grain flour.
Foods rich in fibre and starch
Millet
Barley
Faba beans
Cabbage
Maize
Chickpeas
Wild spinach
Orange
Pumpkin
Apple
Sorghum
peanuts
carrot
Banana
c. Eat less sugar
Sweet tea or coffee, biscuits, cookies, cakes, sweets, sugar, soft
drinks (such as Coca Cola, Fanta, Sprite), jam, and honey provide
5
energy, but their consumption should Remember
be limited. Too much sugar affects the The daily intake of
appetite, removes the important mineral sugar should not be
magnesium, and negatively affects the more than 10 teafunctioning of the immune system. It spoons (50 gram).
also encourages the growth of fungus
(e.g. thrush/Candida) in the mouth, in the stomach and in the
vagina. Sugar should be avoided when a person has a Candida
infection (thrush).
People taking antiretroviral drugs (ARVs) – used to slow down the
progression of the disease in an HIV-positive person – need to be
particularly careful about their sugar consumption. This is because some
of these medicines affect the body’s ability to produce the enzyme insulin,
which is needed to digest the sugar1.
d. Eat animal products regularly
Animal products have a high content of Remember
good proteins. They build and repair the When the body does
body and help to fight infections. If the not get enough food, it
body does not get enough protein, the becomes weak and
immune system will not function cannot fight infections.
properly. Having HIV, the body needs
more proteins. Therefore, HIV-infected people need to eat more
protein-rich foods. Animal protein is found in milk, cheese,
yoghurt, fish, meat, poultry and eggs.
Foods rich in animal protein
Fish
6
Meat
Eggs
Milk
e. Eat pulses, beans, peas and lentils every day
Pulses, beans (e.g. helbet, teteko bqulto – sprouted beans),
chickpeas (e.g. shiro, kolo) or lentils (adese) provide
carbohydrates, proteins, fibre, minerals and vitamins. The
proteins in pulses are not quite as good as the proteins in animal
products. Legume proteins can be improved though by mixing
lentils, beans, chickpeas with small amounts of cereals or
peanuts. This avoids underutilisation of the proteins in the
pulses.
Food rich in plant protein
Chickpeas
Kidney beans
Peanuts
Ways of improving protein quality
A combination of the following foods in the diet improves the
quality of these proteins:
Example
Combination of ingredients
Teteko
Kolo
Helbet
Ministroni
Fetfet
Porridge
Injera tsebehi
Snack
Bqulto
Sandwich
DMK
Alicha
beans + wheat
chickpeas + barley
helbet + sauce
pasta/rice + lentils
bread (henbasha) + yoghurt
flour (millet, wheat) + butter (yoghurt, linseed)
injera (millet, sorghum) + tsebehi (adese, shiro)
pumpkin seeds + milk
bqulto + peanut
bread + peanut butter
wheat + peanut + chick peas
carrot, potato, wild spinach + lentils
7
f. Eat a variety of fresh fruits and vegetables every day
Fruits and vegetables are a good source of vitamins and
minerals. Vitamins and minerals protect the body against
disease.
Fruits and vegetables
Orange
Wild spinach
Papaya
Cabbage
Banana
Garlic
Carrots
Remember – When cooking vegetables:
• they should be washed before cutting and peeling;
• they should be cooked for a short time to prevent loss of nutrients;
• only sufficient water should be used for cooking – using excess
water wastes energy;
• copper utensils should be avoided as these destroy vitamin C;
• water from cooked vegetables can be taken as soup and should not
be thrown away.
g. Limit the consumption of fatty or oily food
Fats and oils are a good source of energy, and they are important
for maintaining weight and helping in the absorption of the fatsoluble vitamins A, D, E and K. They add flavour and texture to
food, and thereby stimulate the appetite. However, high
consumption of fatty or oily food causes obesity, high blood
pressure, high cholesterol and heart disease. Using too much oil
8
can also cause diarrhoea, and it can negatively affect digestion.
Foodsrich
richininfats
fats
Foods
Oil
Butter
Margarine
h. Drink a lot of water and make sure it is clean and safe
Water assists body processes (e.g. digestion), excretions (e.g.
urine and sweat) and is a medium for the transport of vital
materials to the different parts of the body. It makes up about
70% of the human body.
A person needs at least six cups (1.5 litres) of fluid per day to be
healthy. Lack of enough water causes dehydration. Water needs
to be clean and safe, and therefore should be boiled for at least
ten minutes, filtered and stored in a clean container with a lid.
i. Avoid alcoholic beverages
Alcoholic beverages have no nutritional value. They prevent the
body from properly using the nutrients in food, stop the immune
system from working appropriately, cause dehydration and can
affect how medicines work.
1.4 What to consider when selecting food on a daily basis
• Nutrient value and variety of the available foods such as
staples, animal foods, fruits, vegetables, nuts and pulses.
• Meals that are adequate, attractive, stimulate the appetite and
satisfy the needs of the body.
• The costs of the food.
9
Some examples of healthy meals
The following are a few examples of healthy meals spread over
a whole day. They have an average composition of 50% staple
foods, 30% vegetables and fruits, 15% pulses and 5% animal
products. Drink water with each meal and at least six cups per
day.
Healthy meals for a whole day
Meal
What the meal could include
1 Breakfast 2 bread rolls and coffee with 2 teaspoons (10 g)
of sugar.
Lunch
Half an injera (150 g) with 3 chelfa tsebehi
(stew) made of hamili adegi.
Dinner
6 chelfa ministroni (made of rice, potato, carrot
and lentils).
2 Breakfast Porridge with butter and yoghurt.
Lunch
200 g pasta and half a chelfa adese.
Dinner
Half an injera (150 g) with 3 chelfa shiro.
3 Breakfast 1 bread (100 g), 1 egg and 1 cup tea with 2
teaspoons of sugar.
Lunch
1 bread (100 g), 1 cup of boiled beans (fule) and
150 g salad.
Dinner
1 cup of rice with 2 chelfa alicha.
10
1.5 Names of common food products in Eritrean languages
Colour-key to
languages
Tigringa
Tigre
Bilen
Kunama
Hedareb
kawlo
kawlo
-----
----afo-kina
Arabic
Afar
Saho
Nara
English
bunnahe
deqwala emra bunnaahe
sukufa
tefe (noone)
----wild spinach
kawlo
kawlo
kawlo
cabbage
karott
karotta
-----
carrot
karrot
karot
carrot
cebo
cilbo
ootia
maize
bultug
borta
-----
----bultug
bartuu
millet
cheber
---------
ceero (cuureyta)
cuure
keevvo (mir)
aloe
----dubbari feden dubbo daro
dubba oja
dubba tii
pumpkin seeds
----sigem
xaffali
cadeelaw
shiir
barley
11
----sirnay
----fula
besel
sungurita
12
sirraya
sinar
sirnay
wheat
kina
cas-doro
full
ful
ful
peanut
----ataro
basala
shuggurti
bashal
onion
elba
maseela
xaffali
rusa
ruz
sorghum
----catir
atar
chickpeas
cado basal
toma
cado shuggurti
sungutitaara bashal-tum
garlic
----lemuna
ruddi
ruuz
ruz
rice
leemuun
lemuun
lemuun
lemon
--------papaya
babaayo
papaya
babayo
papaya
iv
CHAPTER TWO
Common nutritional problems related to
illnesses and symptoms associated with
HIV and AIDS and some dietary advice
Dietary practices may assist in managing illnesses associated
with HIV and AIDS. However when severe diarrhoea; loss of
appetite due to illness; fever; abdominal pain; vomiting or
bloody stools persist for three days or more, it is important to
seek medical advice to prevent the illness from becoming more
serious.
16
2. Common nutritional problems related to
illnesses and symptoms associated with
HIV and AIDS, and some dietary advice
Illnesses and symptoms often associated with HIV and
AIDS are loss of appetite, weight loss, diarrhoea, fever,
headaches, nausea, vomiting, sores in the mouth, thrush, herpes
zoster and anaemia. The chances of Everyone gets sick at
experiencing these symptoms can be times. Colds, flu,
reduced by eating the right foods. This allergies, diarrhoea,
is especially important when taking vomiting, fever, food
ARV medicines. When experiencing poisoning, upset
any of the above symptoms, eating the stomach and fatigue are
right foods might help to reduce the not necessarily HIV seriousness
of
the
symptoms. related. Anyone can
However, it is still important to get suffer from these
medical advice and the necessary ailments. However, if a
medical treatment to prevent the illness person is infected with
from
becoming
more
serious, HIV, the body needs to
especially when any of the above be given additional help
symptoms persist for three days or (by eating the right
foods) to fight any
more.
ailments experienced.
If frequently experiencing one of the above symptoms, the cause
might be food related. Experiment with the diet to figure out
what is causing the symptoms. For example, try to remove one
food item at a time from the diet, to see whether it makes a
difference. Once the food at the origin of the problem has been
identified, it should be avoided. What affects one person may
not affect others. Everyone will have to find out what suits
him/her best.
17
2.1 Tuberculosis (TB)
Because of their weakened immune system, people living with
HIV AND AIDS can experience opportunistic infections.
Tuberculosis is one of the most common opportunistic
infections. The major symptoms of tuberculosis are cough,
spitting blood and weight loss. The dietary advice mentioned
below will not cure TB, but it can help to strengthen the immune
system to fight the TB infection.
Dietary advice:
• Eat staple foods like injera and porridge made of millet,
wheat, maize and sorghum.
• Eat protein rich foods like chickpeas, beans, fish, meat and
eggs.
• Eat easily digestible food like fermented food (yoghurt,
injera).
• Eat dark green, leafy vegetables such as wild spinach
(hameli), as well as greens, okra or spinach.
• Eat fruits such as banana, watermelons and lemons.
Medical advice:
When suffering from TB, always seek medical advice.
2.2 Herpes zoster
Herpes zoster is a skin condition caused
by a virus that leads to severe burning pain
and a rash of painful blisters that usually
appear on one side of the body (such as the
chest, back, neck or face). People, who are
HIV-infected, are susceptible to repeated
episodes of herpes zoster because of their
damaged immune system. Before blisters
appear, the person may feel fatigue, chills,
fever and/or stomach problems. The area where the blisters will
appear will feel sensitive 3-4 days before the blisters actually emerge.
18
Normally the blisters and the pain will go away after 2-3 weeks.
The following are some suggestions on how to manage the
symptoms associated with herpes zoster through good nutrition.
Remember, it is always best to get advice from a nurse or doctor
to make sure that the illness is properly treated.
Dietary advice:
• Include foods rich in protein, vitamins
and minerals in the diet such as; lean
meat, poultry, fresh fish and
vegetables;
• Pumpkin seeds are a rich source of
zinc, a mineral that can help to stop
the spread of the herpes virus.
Caution:
• Avoid alcohol and coffee, because
alcohol can damage the body’s
ability to fight infection and too
much coffee can cause a runny
stomach.
Warning!
1. Eating too many
peanuts can stimulate
herpes infections
because they contain a
substance called
arginine. To prevent
this, eat peanuts with
either milk or wild
spinach2.
2. Never touch the eyes
after you have touched
the sores; wash hands
immediately.
Care:
• Crush one Aspirin and mix it with two teaspoonfuls of
Vaseline. Gently rub the mixture onto the affected area.
Repeat this 3-4 times a day (Note that you should use Aspirin
and not, for instance, Panadol);
• Place a clean cloth in a cooled mixture of eucalyptus leaves
and water, then place the cloth on top of the affected part of
the body. After use, the cloth should be washed in boiling
water before using it again. This will prevent cross infection;
• Put a few drops of pure lemon juice directly on the affected
area (a short stinging sensation might be felt). Repeat several
times a day until the sores are gone.
19
Medical advice:
• If the blisters lead to other infections of the skin, seek medical
advice immediately.
2.3 Sore throat
A sore throat is usually caused by colds or flu and is normally
not serious.
Dietary advice:
• Crush a lemon and mix the juice with honey. Gargle and drink
a large spoonful as often as necessary.
• Drink tea and plant extracts that help with a sore throat. Take
them for as long as the symptoms last.
Care:
• Gargle a strong solution of salt and water several times a day.
Medical advice:
Consult a health worker when:
• fever develops and persists;
• the patient cannot swallow or breathe;
• the sore throat lasts more than two weeks;
• the pain causes a complete loss of appetite.
2.4 Sore mouth
A sore mouth is a symptom of infections associated with a
weakened immune system.
Dietary advice:
• Chew raw garlic every few hours.
• Eat mashed, soft/smooth or moist foods such as pumpkins,
yoghurt, papaya and banana.
• When eating, dip dry and hard foods in liquid to soften them.
Caution:
For as long as the symptoms persist, it is best to avoid eating the
20
following:
• acidic foods such as lemons and oranges;
• foods that are difficult to swallow;
• foods that contain too much salt or spices;
• foods that are too hot or too cold;
• all forms of sugar (including honey), as they help the infection
in the mouth to grow.
Care:
• Rinse the mouth every 3 hours with warm water mixed with
salt, or with a mixture of baking soda and water.
• Maintain proper mouth hygiene such as brushing teeth and
cleaning the mouth after meals and before bedtime.
2.5 Thrush/Candida
Thrush is a common fungal
(candida) infection in people
living with HIV and AIDS. It
causes white patches on the
gums and on the sides of the
tongue, burning, swelling and
redness in the mouth, sore
throat, difficulty in swallowing, chest pains and vaginal
infections in women.
Thrush sores in the mouth can result in difficulty in eating and
loss of appetite. Because of the reduced food intake, this usually
leads to weight loss. Treatment of thrush is necessary to ensure
sufficient and diverse food intake.
Dietary advice:
• Eat unsweetened foods such as yoghurt - this will help to
prevent the fungus from growing.
• Eat soft, mashed foods such as carrots, scrambled eggs,
mashed potatoes, bananas, soups and porridge.
21
• Eat food cold or at room temperature.
• Eat 1-2 cloves of raw garlic every
3-4 hours. If the raw garlic is too
strong, crush the cloves and mix
with a small amount of clean
(boiled) water. Rinse the mouth
with this mixture and then swallow
the rest. Repeat every 3-4 hours.
Caution:
• Strong citrus fruits and juices
should be avoided – they may
irritate the mouth sores.
• Spicy and salty food may also
irritate the mouth sores.
• Sugar, honey, very sweet fruits,
sweet foods and sweet drinks
(including carbonated soft drinks
such as Coca Cola, Fanta and
Sprite) increase the soreness and
help the fungus to grow.
• Alcohol will also increase the
soreness.
Remember:
1. With oral thrush,
maintain good mouth
hygiene, including
brushing teeth and
cleaning the mouth
after meals and before
bedtime
2. For vaginal thrush,
always ensure that
underwear is well
washed, thoroughly
dried, and ironed.
Warning!
1. People taking ARVs
anti-HIV medicines
Ritonavir or Saquinavir
should not take garlic
at the same time, as
these substances do not
work well with garlic3.
2. People with diabetes
who are taking insulin
should only use garlic in
small amounts4.
Care:
• Gargle with slightly salty, warm, clean water.
• If the thrush is in the anus or vagina, insert raw garlic in the
anus or vagina. Before inserting make sure that the garlic
has been properly washed, peeled, has small cuts and
applied oil over it 5.
Medical advice:
When experiencing any of the following symptoms, a nurse or
doctor should be consulted:
• the thrush going together with fever;
22
• no improvement occurs after a few days;
• pain causes a complete loss of appetite.
2.6 Haemorrhoids/Constipation
Haemorrhoids are itchy or swollen veins in the anal tissue. Their
main causes are long periods of constipation, sitting for too long
(which restricts blood flow to the abdomen), coughing and
obesity.
Dietary advice:
• Eat fibre-rich foods such as fruit, cereals, pulses, kolo, teteko,
bqulto, DMK, CSB and green, leafy vegetables.
Caution:
• Avoid highly spiced foods.
2.7 Anaemia
Anaemia is an inadequate number, or low quality, of red blood
cells in the body. It is caused usually by a poor diet and a lack of
iron in the diet. Infections such as malaria and other parasites
can also lead to anaemia. Headaches, tiredness, irritability, pale
skin colour and dizziness are all signs of anaemia.
Dietary advice:
• Eat foods that are rich in iron such
as spinach, wild spinach (hameli),
pumpkin, beans, peas, helbet,
bqulto, lentils, peanut, pumpkin
seeds, fish, meat, liver and eggs.
• Eat foods rich in vitamin C such as
oranges, lemon, guava, green leafy
vegetables and tomatoes.
Warning!
Do not drink tea or coffee
with a meal or right after
a meal. It is best to wait
at least two hours in order
to allow the iron in the
food to be absorbed by the
body.
Medical advice:
If it is not possible to get enough iron through a normal diet, a
health care provider can recommend other ways to treat anaemia
23
(such as taking iron pills). If an HIV-positive person experiences
headaches, tiredness, irritability, pale skin colour, or dizziness, it
is best to check first with a health provider to make sure that it is
anaemia and not another illness.
2.8 Loss of appetite
Loss of appetite occurs during different infections. It leads to
general weight loss, and is common when individuals are
depressed or living in socially and emotionally unfavourable
environments.
Dietary advice:
• Eat small meals frequently.
• Keep favourite foods nearby to encourage eating.
Care:
• Avoid emotional stress before and during meal times.
• Do some gentle exercise before meals to stimulate appetite.
2.9 Diarrhoea
Diarrhoea is common among people living with HIV and AIDS.
It results in loss of water and essential nutrients, and leaves a
person at greater risk of dehydration. Diarrhoea also reduces
appetite and causes weight loss because the food does not stay
long enough in the digestive tract to be properly absorbed.
The main causes of diarrhoea are infections (by bacteria,
parasites or a virus) due to the drinking of unclean water or
other forms of poor hygiene. Diarrhoea may also be a side-effect
of medication or the result of malabsorption, when the food is
not absorbed in the intestine. A person might also experience
diarrhoea if he or she takes ARV medicines incorrectly.
Therefore, it is important to follow whatever instructions given
by the health care provider and tell him or her about any
symptoms that one is experiencing.
24
Dietary advice:
• Take plenty of fluids such as clean (boiled) water, fruit juices,
soups, rice water, light porridges made of maize or Oral
Rehydration Salts (ORS) to prevent dehydration.
• Eat fruits such as papaya, ripe bananas and mangoes.
• Prepare and eat rice soup.
• Drink fermented milk (yoghurt) 3-4 times a day.
• Drink garlic tea.
• Eat small meals frequently, as well as snacks.
• Eat slowly.
• Eat food warm, rather than very hot or cold.
• Eat bananas and rice, which can slow the progress of
diarrhoea.
Caution:
• Try to avoid raw and cold foods.
• Do not eat foods that are too high in fibre (e.g. kolo, teteko).
• Be careful with fresh milk.
• Avoid foods that are too sugary.
• Foods high in fat, such as fried foods, margarine, butter and
oils sustain diarrhoea.
• Coffee, tea and alcohol can worsen dehydration.
• Very spicy foods such as chillies and pepper can cause
diarrhoea.
• Foods that produce gases, such as beans, broccoli, cauliflower,
cabbage, onions and green pepper are to be avoided.
• Do not eat food, which might be contaminated or infected.
Care:
• Get plenty of rest.
• Try remaining quiet and rest a bit after meals.
Medical advice:
Most diarrhoea goes away after a few days with proper care.
However, seek medical advice when any of the following occur:
• there is blood in the diarrhoea;
25
• the diarrhoea is accompanied by fever;
• the patient is too weak to eat or very dehydrated and efforts to
rehydrate are not working;
• the diarrhoea does not go away after 2-3 days.
Preparing oral rehydration drink6
From ORS packets
Follow the instructions and dissolve the
contents of the packet in the amount of
clean (boiled) water stated on the
packet.
(ORS = Oral Rehydration Salts)
With powdered cereals
Take one litre of clean (boiled) water,
add half a teaspoon of salt and eight
teaspoons of powdered cereals. Rice is
best, but finely ground wheat flour,
maize, sorghum or cooked mashed
potatoes can also be used. Boil for 5`````7 minutes to make a liquid soup
(broth) or watery porridge. Cool the
drink quickly.
2.10 Weight loss
The body needs extra nutrients to fight off infections. Serious
weight loss is a common problem among people with HIV and
AIDS. It may be caused by a loss of appetite due to illness or
use of medicines, increased nutrient need during periods of
infection, possibly combined with the difficulties of the body to
absorb nutrients or parasite infections. Symptoms such as sore
mouth, diarrhoea, nausea and vomiting may make it hard to eat,
thus lowering food intake. Isolation and depression tend to
26
affect the appetite, as does the lack of variety in food, often
caused by economic hardship. When a person living with HIV
and AIDS loses weight, he or she needs to take action to return
his or her body weight to its normal level.
Dietary advice:
• Eat a variety of foods on a daily basis. Foods good for weight
gain are rice, maize, millet, sorghum, injera, porridge, wheat
and barley (tehni), peas (kolo, teteko), peanuts, beans
(helbet, bqulto) lentils, DMK, potatoes, meat, fish, chicken,
eggs, full-cream milk, banana and fermented foods.
• Eat small amounts of food more frequently (eat less, but more
often), at least 5 times per day (minimum every 3 hours).
• To help digestion and absorption, squeeze fresh lemon juice
over fatty foods or add the grated skin of oranges and lemons
(be sure to wash the skin well before grating) to fatty foods
like meat, chicken and nuts.
• Eat the inner part of the skin of a lemon or orange with meals.
This contains pectin, which holds the food longer in the
stomach, allowing better absorption.
• Eat garlic, seeds and leaves of papaya, pumpkin seeds and
carrots to help the stomach stay clean.
• Eat protein-rich foods such as meat with papaya fruit or
(crushed) seeds to help the stomach digest the protein.
• Eat food that contains selenium every day (see Chapter 3). The
body needs selenium to build muscles. Examples of foods with
selenium include aloe juice, sunflower seeds, nuts and sea fish.
Caution:
• Avoid eating too much fatty and fried food.
Care:
• Exercise regularly because it improves the appetite while also
improving the functioning of the digestive system. Exercise also
helps to increase energy and strength while building muscles. Do
not exaggerate and stay within the body’s capacities.
27
• Daily activities such as cleaning, working in the field,
walking, jogging, swimming and aerobics are good ways to
exercise. They also help to relieve stress.
2.11 Nausea and vomiting
Nausea and frequent vomiting can be the result of drugs used to
treat HIV and AIDS – especially when those drugs are taken at
the wrong time of the day or with the wrong combination of
foods – or from opportunistic infections. Nausea also leads to
reduced appetite and poor utilisation of the food consumed.
Dietary advice:
• Eat small and frequent meals and avoid having an empty
stomach (nausea is worse when the stomach is empty).
• Drink plenty of fluids after meals.
• Eat foods such as soups and fruits (bananas).
• Eat lightly dried and salty foods like crackers and cereals to
calm the stomach.
• Drink lemon juice in hot water or herbal tea.
• Drink ginger tea.
Caution:
• Avoid foods that make you feel ill.
• Reduce consumption of fatty, spicy and very sweet foods.
• Caffeine (found in coffee, tea, and chocolate) and alcohol can
increase the feeling of nausea.
Care:
• Do not lie down immediately after eating. Wait at least 20
minutes to avoid vomiting.
• Sometimes the smell of food while cooking may worsen the
feeling of nausea. Therefore, try to avoid preparing food while
experiencing nausea.
28
2.12 Fever
People with fever may have chills or
sweat more. They may also experience
muscle and joint aches or fatigue. Fever
is common in people with HIV and
AIDS, and it does not necessarily
indicate another serious illness. Fever
may result in increased nutrient
requirements, as the body utilizes more
nutrients to fight fever.
Dietary advice:
• Drink citrus (lemon and orange) juice several times a day.
• Drink tea from lemon and guava.
• Drink neem tea.
• Eat soups that are rich in energy and nutrients, like soups of
maize, potatoes and carrots.
• Drink plenty of fluids.
Care:
• Pound eucalyptus leaves in a mortar with a small amount of
cooking oil. Rub the oil onto the patient’s chest. Leave the pot
in the patient’s room so the vapours can be inhaled.
• Cool down the body by sponging with a wet cloth.
Medical advice:
Consult a nurse or doctor if the fever:
• persists;
• gets too high and the patient is very hot; or
• is accompanied by other signs of serious illness.
2.13 Headache
People with HIV and AIDS may experience headaches for a
variety of reasons. Headaches may also be caused by many
illnesses other than infection with HIV.
29
Dietary advice:
• Drink garlic and onion tea.
Care:
• Take Aspirin or Panadol with a cup of clean (boiled) water.
Please note that taking Aspirin while having a high fever
might be dangerous.
• Take sufficient rest.
2.14 Colds and influenza (flu)
Colds and influenza (flu) are common infections caused by
viruses.
Dietary advice:
• Drink plenty of water or other fluids.
• Drink sibko.
• Prepare special teas for colds and drink them for as long as
the symptoms last.
Care:
• Have plenty of rest.
2.15 Cough
Coughing is not a sickness by itself but a sign of several
different sicknesses that affect the throat or lungs.
Dietary advice:
• Drink lots of warm water or other warm fluids.
Care:
• Take a bowl or pot filled with very hot water with eucalyptus
or mint leaves. Cover the head with a towel while bending
over the bowl and pot, allowing the vapours to concentrate
around the head. Breathe in the hot vapours deeply for ten
minutes. Do this twice a day.
• Use onion tea or cough syrup to ease the symptoms.
30
CHAPTER THREE
Food recommended to better fight
HIV and AIDS
Good nutrition cannot cure AIDS or prevent HIV infection, but
it can help to maintain and improve the nutritional status of a
person with HIV and AIDS and delay the progression from HIV
to AIDS.
34
3. Food recommended to better fight
HIV and AIDS
3.1 Foods rich in selenium
Selenium is a mineral, which is very important to keep people
living with HIV and AIDS healthy. The progression from HIV
to AIDS can be slowed down when sufficient amounts of
selenium are consumed on a daily basis. One or a combination
of the foods listed below should be eaten every day.
Food rich in selenium
Aloe leaves
Fish
Pumpkin seeds
Chicken
Eggs
Peanuts
Meat
Examples of food containing a full day’s requirement of
selenium7:
- 150 g canned sardine in oil.
- 3 melekia (25 ml) of aloe juice daily (one melekia with every
meal breakfast, lunch and dinner).
- one cup of shelled sunflower seeds.
Selenium supplement pills
When taking selenium supplement
pills, ensure that they either contain
vitamin E or combine them with food
rich in vitamin E such as leafy
vegetables, vegetable oil, peanuts, egg
yolks and whole-grain cereals.
Warning!
Do not consume more
than 450 µg per day.
This total could be
achieved through a
combination of selenium
pills and food8.
35
A cheap, easily available and efficient source of selenium is the
juice of aloe.
Aloe juice (Ere)
Aloe juice is made from the inner soft
white parts of aloe leaves.
• It is a good source of selenium.
• Helps the body in fighting HIV and AIDS.
• Strengthens the immune system.
• Helps the stomach to better digest
protein because it contains pectin.
• Helps the body to maintain and gain weight.
A teaspoon of aloe juice with a meal
can help people experiencing weight
loss keep their weight stable.
It is recommended to drink some aloe
juice every day.
3.2 Foods rich in zinc
Warning!
The outer green section
of the aloe leaf is very
bitter and causes
diarrhoea. Do not use
the outer green parts of
the leaf if you want to
gain weight.
Zinc is a mineral, which is very important in fighting infections,
including HIV. Ensuring they have sufficient zinc in their diet is
therefore important for people living with HIV and AIDS.
Foods rich in zinc
Wild spinach
Pumpkin seeds
Peanuts
Foods rich in zinc should be eaten in combination with food that
contains vitamin A such as carrots and mango.
36
Preparation of aloe juice9
1. Get two medium-sized aloe leaves
(about 25 cm long each), which are
sufficient for one month’s supply
for one person.
2. Remove the green skins of the
leaves completely and keep only
the inner, white parts for making
the juice.
3. The inner white part of the two
leaves is quite soft, like jelly. Chop
it up finely in a bowl while being
careful not to lose any of the
liquid.
4. Add the aloe juic e to one litr e of
clean (boiled) water and pour in a
bottle.
5. Add two tablespoons of alcohol
(zebib, congac, gin or whisky) in
order to ensure that the mixture
does not ferment and go bad.
6. A small amount (about one-third
of a small cup) should be taken
every day. One litre should last for
one month, for one person. Always
mix the contents of the bottle
thoroughly before pouring.
If religion does not allow
the use of alcohol, the
juice can be prepared
without alcohol and
stored in a freezer to
avoid fermentation. A
smaller quantity could
also be made, though it
will have to be prepared
more often.
7. Add some sugar or honey to taste,
as aloe juice tastes bitter.
37
Examples of food containing a full day’s requirement of
zinc10:
- two-and-a-half (2 ½) cups of wild spinach (hameli adegi),
including the leafstalks.
- one-and-a-half (1 ½) cups of pumpkin seeds.
- two cups of shelled sunflower seeds.
- three cups of roasted peanuts.
3.3 Foods rich in vitamin A/beta-carotene
Vitamin A keeps the body strong and helps it to fight HIV.
Foods rich in vitamin A
Carrots
Wild spinach
Cabbage
Examples of food containing a full day’s requirement of
vitamin A11:
- one-and-a-half (1 ½), medium sized raw carrots.
- one-and-three-quarter (1 ¾), medium sized boiled carrot.
- seven cups boiled wild spinach leaves.
3.4 Foods rich in vitamin B12
Vitamin B12 helps the body to stay strong, and can help to fight
HIV and AIDS. Insufficient intake of vitamin B12 is a cause of
anaemia and depression.
38
Foods rich in Vitamin B12
Beef liver
Red meat
Sardines
Milk
Poultry
Eggs
Maize
Sorghum
Examples of food containing a full day’s requirement of
vitamin B1212:
- 30 g of beef liver.
- 200 g of canned sardines.
3.5 Foods rich in vitamin C
Vitamin C increases resistance to infection and improves the
absorption of iron. Insufficient intake of vitamin C may increase
the susceptibility to diseases like anaemia.
Foods rich in vitamin C
Tomato
Papaya
Chilli pepper
Lemon
Cabbage
Orange
39
Examples of food containing a full day’s requirement of
vitamin C13:
- 1 or 2 papayas or guavas per day.
- 2 or 3 chili peppers per day.
- 2 or 3 cups cauliflower per day.
- 3 oranges per day.
Avoid smoking – every cigarette you smoke destroys 25 mg of vitamin
C in your body14.
3.6 Garlic
Garlic strengthens the immune system. It
helps fight infections caused by viruses,
bacteria and fungi. Eat garlic regularly and
in sufficient amounts; 2-``3 cloves of garlic
per day will prevent many infections.
Garlic is best chopped into pieces and
eaten raw.
3.7 Cabbage
Cabbage is a rich source of calcium, vitamin A, vitamin C and
sulphur. Cabbage:
• strengthens the immune system;
• works very well to settle an acid stomach;
• controls infections, heals ulcers and
inflammation;
• sour cabbage water is a remedy for
digestive problems.
Cabbage is best eaten raw.
40
CHAPTER FOUR
Safe hygienic practices when dealing
with food
Good nutrition cannot cure AIDS or prevent HIV infection, but
it can help to maintain and improve the nutritional status of a
person with HIV and AIDS and delay the progression from HIV
to AIDS.
44
4. Safe hygienic practices when dealing
with food
People living with HIV and AIDS are more vulnerable to food
poisoning because their immune system has already been
weakened. Therefore, people having HIV or people who prepare
food for HIV patients need to follow strict hygienic foodhandling practises.
1. Use safe and clean water. If the water is not clean, it should
be boiled for 10 minutes before drinking or using. Boiled
water needs to be stored in a clean
container with a lid.
2. Always wash hands with clean
water and soap before, during and
after preparing food or eating. Do
this also after visiting the toilet.
Dry hands with a clean cloth or
towel.
3. Cover all wounds to prevent contamination of the food during its
preparation and handling.
4. Keep food preparation surfaces
clean. Use clean dishes and
utensils to store,
prepare, serve and eat food.
Thoroughly
wash utensils and surfaces where you place uncooked foods,
particularly meat and fish.
45
5. Thoroughly wash fruits and
vegetables with safe, clean,
preferably boiled, water before
eating, cooking or serving. Peel the
skin and cut off bruised parts, if it
is not possible to wash them
properly.
6. Cooking
destroys
harmful
bacteria and germs. Therefore,
cook all animal products like
meat, fish and eggs at high
temperatures until well
done. Do not eat soft-boiled eggs or meat that still has red
juice.
7. Do not eat raw eggs, raw milk, raw meat or homemade
mayonnaise.
8. Food should be eaten as soon as it is cooked. Avoid storing
leftovers unless they can be kept in a refrigerator or a cool
place. Do not store them for more than one or two days and
always reheat them at high temperature, to kill possible
harmful germs, before eating.
9. Do not store raw and cooked foods together. Use containers
in order to avoid contact between them.
10. Cover food to prevent insects, flies, rodents and dust from
contaminating the food.
46
11. If food products have expiration labels, do not eat or prepare
meals with those products after the expiration date.
12. Do not keep prepared food in metallic dishes for a long
period. It is better to use plastic containers.
12. Do not use ice in drinks, as the water used to make the ice
might not have been safe to drink.
47
48
44
CHAPTER FIVE
Herbal and heat treatments
Good nutrition cannot cure AIDS or prevent HIV infection, but
it can help to maintain and improve the nutritional status of a
person with HIV and AIDS and delay the progression from HIV
to AIDS.
52
5. Herbal and heat treatments
5.1 Keeping the body temperature warm to better
fight HIV and AIDS15
The normal body temperature of an adult is
approximately 37 degrees Celsius. When the
body is warm, or just a little warmer than
normal, it can better fight HIV (or any other)
infection. This is because heat increases the
body’s ability to fight infections.
A body’s temperature is lowered by:
• being tired or exhausted – because the
body cannot generate enough energy to stay
warm;
• staying outside in the cold, especially when it is windy;
• not enough exercise – because the body is not working;
• a lack of certain essential nutrients such as calcium and
magnesium;
• not having enough energy-rich food components (fats and
carbohydrates) in the diet;
• swimming or being wet during rain – as it drains away body
heat.
Dietary advice:
• Eat more foods rich in calcium and
magnesium. Milk, yoghurt, cheese,
potatoes, peanuts and wild spinach
are rich in calcium. Cabbage, wild
spinach and ordinary spinach are rich
in magnesium.
Take either cayenne pepper (kehi
gu’u), ginger (powdered/finely chopped),
chilli powder (berbere) or raw chillies
For the best effects,
calcium-rich foods
and magnesium-rich
foods are not eaten
together but at
different times. For
example, drink milk
in the morning and
eat cabbage at lunch.
53
(finely chopped) three times a day. For the
best effects, mix a quarter (1/4) teaspoon of
one of these spices with a glass of water, milk
or fruit juice, then stir and drink16.
Warning!
Avoid cayenne pepper, ginger, or chilli when having stomach
or intestinal problems such as ulcers or gastritis. People who
have a heart condition, including high blood pressure, should
also be careful when using these spices17.
Care:
• Rest properly and do not work when tired.
• Exercising keeps the body’s temperature higher, but one
should not exaggerate.
5.2 Herbs: their benefits and how to use them
Herbs can be used to strengthen the body’s immune system, help
to treat common illness such as diarrhoea and nausea, improve
digestion, stimulate appetite and preserve foods. These herbs
represent alternatives to formal medicine; they are locally
known and are easily available for many people.
Some herbs are good and safe to use by most people, provided
the maximum amounts prescribed are not exceeded. Excessive
use (in other words, taking more than the prescribed amounts)
may cause problems and have toxic effects (and is harmful).
One should always start with small amounts, to ensure that one’s
body is not allergic to the specific herb. When experiencing any
unexpected reactions, one should immediately stop using that
herb and seek medical advice.
Herbs, like vitamin and mineral supplements, cannot replace
healthy eating and should not be used as a substitute to a healthy
and balanced diet.
54
Herb
Aloe
•
•
•
•
Benefits
Has high levels of selenium. •
Fights HIV.
Relieves constipation.
Helps to gain weight.
•
•
Basil
• Helps to relieve nausea.
• Helps digestion.
• Has an antiseptic function
for mouth sores.
Cardamom
• Helps with digestive
Cayenne
•
•
•
•
Camomile
•
•
Cinnamon
•
•
•
•
•
•
•
•
•
How to use18
Use as extract; boil and
drink the concentrated
water.
To be used in limited
amounts.
Stop immediately
should it cause cramps
or diarrhoea.
Add to food to treat
nausea and digestive
problems.
Use as gargle for
mouth sores.
Add to food during
cooking.
Prepare as tea.
problems, pain, diarrhoea,
nausea, vomiting.
•
Helps with loss of appetite.
Stimulates appetite.
• Add a pinch to cooked
or raw foods.
Helps fight infection.
Heals ulcers and intestinal • For an energizing
inflammation.
drink, add to fruit juice
or water.
Helps digestion.
• Prepare tea from the
Provides relief from nausea. leaves and flowers and
drink several cups
throughout the day.
Good for colds and for
• Add to meals.
weakness after colds or flu. • Use in tea, particularly
Use when feeling cold.
ginger cinnamon tea
Good for diarrhoea and
for cold or tuberculosis.
nausea.
Stimulates appetite.
Gently stimulates digestive
juices.
Encourages bowel
movements.
55
Herb
Cloves
Eucalyptus
Benefits
• Stimulates appetite.
• Helps to improve digestion,
•
•
•
Fennel
•
•
•
Fenugreek
Garlic
•
•
•
•
•
•
Ginger
•
•
•
•
•
•
56
How to use
• Use in soups, stews,
diarrhoea, nausea and
vomiting.
Has antibacterial function,
•
particularly for lungs and
during bronchitis.
•
Eucalyptus oil from leaves
increases the blood flow.
Eucalyptus oil reduces the
symptoms of inflammation.
Helps to increase appetite.
•
Combats flatulence and
•
expels gas.
As mouthwash for gum
•
disorders.
Helps to gain weight.
•
Reduces effects of herpes
•
zoster.
Control blood sugar levels.
Has antibacterial, antiviral
•
and antifungal function,
•
particularly in the gut,
•
intestines, lungs and vagina.
Helps digestion and feeling of
weakness.
Also good for thrush, throat
infections, herpes and
diarrhoea.
Improves digestion.
•
Energizes.
Relieves diarrhoea.
•
Stimulates appetite.
Used for treating common
colds and flu.
Used for treating nausea.
warmed fruit juice
and tea.
Prepare as tea from
the leaves.
Make extract.
Add as spice to foods.
Prepare as tea from
the seeds.
Use in limited
amounts.
Prepare as Helbet.
Used for flavouring
pickles.
Drink as tea.
Eat raw.
Use as energy drink.
Use as a spice in
meals.
Drink as ginger tea.
Herb
Lemon
Benefits
• Works as an antibacterial.
• Helps digestion.
How to use
• Add lemon juice to
food.
• Add lemon juice to
drinks.
Lemon grass • Has a calming effect on the • Use as tea.
digestion.
• Alleviating stress.
Mint
• Has anti-inflammatory effect. • Use as tea.
• Helps digestion.
• Gargle for mouth
sores.
• Chew mint leaves to
aid digestion.
Neem
• Reduces fever.
• Cut a fresh twig,
remove the leaves
and boil the bark in
water; drink as tea.
• The bark can also be
chewed.
Parsley
• Reduce intestinal colic.
• Add raw or cooked to
• Stimulates stomach secretions food.
and activities.
• Produces a feeling of hunger.
• The seed is used to remove
excess water from the body.
Thyme
• Reduces colds and sore throat. • Use as a spice in
• Has antiseptic and antifungal meals.
• Use as gargle or
function.
mouth wash.
• Stimulates digestion and the
growth of the intestinal flora. • Drink as thyme tea.
• Make thyme extract.
• Helps with thrush/Candida
infections.
Turmeric/
• Digestive aid.
• Use powdered in
yellow root • Antiseptic.
rice, cereals, etc.
• Antioxidant.
57
5.3 Common Eritrean herbs
Cinnamon – ቃርፋ
Cloves –
ቅንፍር
Thyme – ጠስነ
Camomile –
58
ካማሜላ
Ginger –
ጅንጅብል
Cardamom –
Turmeric –
Basil –
ሄል
ህሩድ
ሰሰግ
Garlic – ጻEዳ
ሽጉርቲ
Fenugreek – ኣባEከ
Parsley –
ፐርሰሜሎ
Lemon – ለሚን
Fennel –
ፌኔል
Neem – ኒም
Mint –
ናEናE
Lemon grass – ሳEሪ
Eucalyptus –
ለሚን
ቀላሚጥስ
59
60
CHAPTER SIX
Eritrean recipes for foods and drinks
Good nutrition cannot cure AIDS or prevent HIV infection, but
it can help to maintain and improve the nutritional status of a
person with HIV and AIDS and delay the progression from HIV
to AIDS.
61
62
6. Eritrean recipes for foods and drinks
The recipes selected hereafter are suggestions for foods and
drinks that may help to address some of the common
complications arising from HIV and AIDS. Recipes should be
adapted to locally available foods and preferences and there may
even be variations and different ways to prepare these dishes
and drinks. When using alternative spices, the recommendations
given in the previous chapters of which spices to avoid/use
when experiencing specific conditions should be kept in mind.
The recipes are grouped to cover common dishes, soups, teas
and drinks, snacks and other useful recipes. For each recipe a
number of a conditions or ailments are given in which this might
be of use, followed by the ingredients – indicating the number of
servings this prepares – and a way to prepare the dish.
People living with HIV and AIDS may have problems in
digesting fat (particularly when they are suffering from
diarrhoea). Traditionally the Eritrean kitchen tends to use
considerable amounts of oil and fats. Therefore it is best to limit
the amounts of oil and fats used in these recipes, especially
when cooking for people living with HIV and AIDS.
6.1 Common dishes
Adese (Timtimo)
Indications: weight gain.
Ingredients – serves 4: 2 cups lentils or split beans, 2 onions, 3
garlic cloves, 3 tomatoes, 1 tablespoon berbere (chilli powder),
oil and salt.
Preparation: Boil the lentils (split beans) in water until soft.
When done set aside. Fry the onion in oil. When soft add
tomatoes, garlic and berbere. Cook until the mixture (sauce) has
63
a red colour. Add the lentils or split beans, water and stir well.
Cook for about 20 minutes. Add salt to taste.
Alicha with vegetables
Indications: constipation, haemorrhoids, weight gain.
Ingredients – 3 servings: ½ cabbage chopped, 2-3 potatoes
peeled and cubed, 2-3 chilli peppers sliced lengthwise into
strips, 3 carrots chopped, 6-7 leaves of spinach, a pinch of salt, 1
teaspoon alicha spice, 1-2 onions chopped, 8 cloves of garlic
chopped, water and oil.
Preparation: Sauté onions and garlic in 2 tablespoons of oil.
When soft, add all the other ingredients to a large pot. Cover
with water. Add alicha spice and stir. Bring to boil and then let
simmer for between 45 minutes to an hour until the liquid is
gone. Salt to taste.
Alicha with lentils
Indications: weight gain.
Ingredients – 5 servings: ½ kg lentils, 2 cups onion chopped, 2
cups oil, 1 cup tomato chopped, 1 teaspoon alicha spice, 5
cloves of garlic, water and oil, pinch of salt.
Preparation: Similar to the recipe above.
Beans and tomatoes (easy and fast to prepare)
Indications: weight gain.
Ingredients – 2 servings: 1 medium-sized tin of baked beans, 1
medium-sized tin of tomatoes or 5 fresh tomatoes, parsley, basil
leaves.
Preparation: Mix the beans and tomatoes together. Bring to boil
and simmer slowly for ten minutes. Add freshly chopped herbs
and the recipe is ready. One may also add minced meat or
64
chopped leafy greens and simmer together with the vegetables.
Bean broth
Indications: diarrhoea.
Ingredients – 3 servings:
teaspoon salt.
2 cups beans, 4 cups water, ½
Preparation: Boil the beans (using more water than usual) until
they are well cooked. Drink the broth or use it to make soups.
Bean broth is good for people who do not have diarrhoea.
½ a cup of rice, maize meal or millet can also be boiled with the
broth to add carbohydrates, thus increasing the energy content of
the broth.
Cowpea paste
Indications: herpes zoster, tuberculosis, weight gain.
Ingredients – 2 servings: 1½ cups boiled cowpeas, water, salt, 1
tablespoon grated onion, 1 teaspoon margarine, 1 tablespoon
lemon juice.
Preparation: Boil the peas in water with a little salt until very soft.
Mash to make a smooth paste. Add onion, margarine and lemon
juice and mix.
Green vegetables stew
Indications: haemorrhoids, constipation, weight gain.
Ingredients – 3 servings: 3 cups greens or other vegetables
(such as cabbage, pumpkin, green beans and peas), 2 onions,
garlic, 1 teaspoon ginger, 1 teaspoon cinnamon, coriander or
mild curry powder, 2 pieces cayenne (if you like a hot taste), oil,
250 gram chopped meat (optional: use bones or mince), water,
3 carrots, 2 tomatoes, 3 potatoes, 1 teaspoon lemon juice.
65
Preparation: Chop and fry the onions, garlic and spices at a low
temperature (small flame) in a little oil. When the onions are brown, add
the meat and water. Cook the meat at high temperature (large flame)
until well done and soft. Chop and add the vegetables except the greens.
Cover and simmer until the vegetables are soft. Chop and add the
greens and let simmer for another ten minutes before the dish is ready.
Add lemon juice to help digestion.
Hameli adegi (wild spinach)
Indications: haemorrhoids,
tuberculosis, weight gain.
constipation,
herpes
zoster,
Ingredients – 2 servings: 1 bunch hameli adegi/wild spinach, 12 onions chopped, 4-6 cloves garlic, 1-2 chilli peppers, salt, 1-2
teaspoon alicha spice and oil.
Preparation: Wash and chop the wild spinach. In a pot, sauté
the onions, garlic and chilli peppers until the onions are soft.
Add wild spinach with half (½) a teacup of water. Add alicha
spice and mix well. Cover and cook for 10-20 minutes. Add salt
to taste.
Helbet
Indications: anaemia, herpes zoster, tuberculosis, weight gain.
Ingredients – 15 servings: ½ kg faba beans, 125 g fenugreek,
160 g lentils.
Preparation: Wash all the ingredients. The ingredients are
soaked separately in the water for almost one day. Drain off the
water after one day. Keep covered for almost 3 days so they can
sprout. After sprouting, dry in the sun. After drying beans and
lentils, have to be stoned in order to remove the fibre. Wash and
mix all three ingredients and mill them together. Sieve the flour
and store in a clean container.
Mix the flour and water in a dish and bring to a boil. Stir
66
frequently for 15 minutes. Serve hot with sauce.
Henbasha (Bekeo)
Indications: weight gain.
Ingredients –5 servings: 4 cups wheat flour, ½ teaspoon salt, 1
tablespoon yeast, 1 tablespoon oil (margarine), 2 tablespoon
sugar, about 2 cups water.
Preparation: Melt the yeast in lukewarm water. Sift the flour
and salt into a bowl. Add sugar, melted yeast and ½-cup water.
Mix the mixture by adding ½-cup water at a time. Leave the
mixture in a warm place for about 20 minutes to rise. When the
mixture has raised, knead and wait for 10 minutes. Subsequently
bake the dough in mogogo (or pan with cover) at a temperature
of 150 - 180 0C for about 15 to 20 minutes. To increase the
protein quality of the product bqulto flour (flour of sprouted
beans) can be added.
Injera
Indications: weight gain.
Ingredients – 5 pieces: 5 cups sorghum (or maize) flour, 2½
cups millet flour, 2½ cups wheat flour, 4 cups starter, 14 cups
water.
Preparation: Place flour, starter and 1 cup water in a melesi
(bowl). Mix the mixture by adding ½-cup water at a time. Knead
the mixture as much as possible up to when it reaches the right
consistency (water to the flour ratio). Cover the melesi with a
cloth or hard cover and place at room temperature (20 – 22 0C)
for 2 to 3 days in order to ferment.
After fermentation a portion of the batter is mixed with three
parts of water and boiled (this is called lafa). The boiled batter is
returned to the main part of the batter and the mixture is allowed
to ferment for another 2 hours during which time the batter
67
becomes thoroughly leavened and acidic.
The batter is then steam-baked in a mogogo with a tight cover at
150 - 180 0C temperature for about 2 to 3 minutes. When not
mogogo is available, a traditional pan with cover can also be
used.
Minestrone
Indications: constipation
Ingredients – 3 servings: 4 tablespoon oil (margarine), 2
tomatos chopped, 2 onions chopped, 1 chilli pepper, 2 carrots
grated, 1 cup lentils, 2 potatoes chopped, 2 cups macaroni, salt,
about 6 cups water.
Preparation: Fry onions in oil. When soft, add tomatoes, grated
carrots, potatoes, parsley, lentils and chilli pepper. Add water
little by little and let boil until well done and soft. Add macaroni
and let cook for another 10 minutes. Add salt to taste.
Mixed beans with spinach
Indications: weight gain.
Ingredients – 4 servings: 2 cups mixed beans, 4 water, salt, 2
onions, 2 cloves garlic, 2 tablespoon margarine or oil, 2
tomatoes, 1 bunch spinach or other green leaves, 2 pepper.
Preparation: Boil beans. Fry chopped onions and garlic in a
little margarine or oil. Add chopped tomatoes, boiled beans and
bring to boil. Add chopped spinach or other green leaves and
pepper. Cover and simmer slowly until the leaves are soft.
Porridge
Indications: weight gain.
Ingredients – 3 servings: 3 cups wheat flour, barley flour or
millet flour, ½ teaspoon salt, 4 cups water.
68
Preparations: Heat-treat the flour for 10-15 minutes on a pan.
Boil water. Safe 1 cup hot water for later use. Add the salt and
flour, and keep stirring while adding the saved water little by
little to avoid lump formation. Keep over a flame until the
porridge becomes very stiff. Serve with butter, yoghurt or
linseed sauce.
Add sprouted cereals or legumes flour to make the product more
nutritious.
Pumpkin stew
Indications: weight gain.
Ingredients – 4 servings: 3 cups chopped pumpkin, 250 g beef.
Preparation: Boil beef with chopped pumpkin until very soft.
Mash the pumpkin. Cut the beef into small pieces and add to the
pumpkin.
Rice, maize or millet can also be boiled with the stew to add
carbohydrates for more energy.
Shiro
Indications: weight gain.
Ingredients – 4 servings: 4 tablespoon oil, 3 tomatoes chopped,
1 onion chopped, 1 chilli pepper, 1 cup shiro powder (the
quantity added depends on the thickness desired), salt, about 5
cups water.
Preparation: Fry onions in oil. When soft, add tomatoes and
chilli pepper. Fry until tomatoes are cooked. Add water and let
boil. When the water is boiled, add the shiro little by little. Stir
continuously for about 2-3 minutes to prevent lump formation.
Turn heat down and let simmer for 20-30 minutes.
Tihni (Tihini, tehni)
Indications: constipation, haemorrhoids.
69
Ingredients – 3 servings: 2 cups tihni (also called tehen, tehni)
flour, ½-teaspoon salt, 1 tablespoon oil or butter, 6 cups water.
Preparation: Boil water. Add the salt and oil. Remove the hot
water from the fire and add the flour. Let simmer over a small
fire until the tihni becomes stiff. Serve with tea, milk or coffee.
It is also possible to use DMK or CSB instead of tihni.
Vegetable stew with meat
Indications: constipation, haemorrhoids, weight gain.
Ingredients – 4 servings: 250 g meat, 2 onions, 3 carrots, 5
potatoes, oil, water, 2 cloves garlic, salt, pepper.
Preparation: Cut meat and vegetables in small pieces. Fry meat
until brown, add onion and fry together. Add the other
vegetables, water and chopped garlic and cook until tender.
Season to taste with salt and pepper.
6.2 Soups
Carrot soup
Indications: diarrhoea, sore mouth, sore throat.
Ingredients – 2 servings: 4 carrots, pinch of salt, 1 teaspoon
ground cinnamon, 4 cups water.
Preparation: Chop carrots finely. Steam until soft. Strain
through a fine strainer. Add water to form a soup. Add a pinch
of salt and ground cinnamon.
Carrot and onion soup
Indications: diarrhoea.
Ingredients – 2 servings: 3 tablespoons margarine, 6-8 medium70
sized carrots, 1-2 medium-sized onions, 1 teaspoon of salt, ½
cup rice (uncooked), 4 cups water and 1¼ cups hot milk.
Preparation: Heat margarine in a heavy pot and gently sauté
carrots, onions and salt for about 5 minutes. Add rice and stir
into mixture. Add water and cook until rice is very well done;
about 45 minutes. Return soup to the pot and add hot milk to the
preferred consistency. Do not let it boil. Keep hot until serving
time.
Lentil or split pea soup
Indications: herpes zoster, weight gain.
Ingredients – 2 servings: 1½ cups dried lentils or split peas, 4
cups water, 2 cups vegetables (carrots, potatoes, greens or
other), salt, garlic.
Preparation: Soak lentils or split peas in water overnight. Cook
until soft. Add chopped vegetables and cook until the vegetables
are soft. Add salt and garlic to taste.
Pumpkin soup
Indications: diarrhoea, sore mouth, sore throat, thrush.
Ingredients – 2 servings: 3 cups pumpkin, 1 onion, 2 cloves
garlic, 1 teaspoon cinnamon, oil, water.
Preparation: Chop the pumpkin, onion and garlic. Fry the
onion, garlic and cinnamon in a little oil. Add the chopped
pumpkin. Add water and bring to boil. Simmer until the
pumpkin is very soft.
Rice soup
Indications: diarrhoea, sore mouth, sore throat, thrush.
Ingredients – 2 servings: 1 cup rice, 4 cups water, salt.
71
Preparation: Add one cup of rice to four cups of salted water.
Cover the pot, bring to boil and cook until soft (about 40
minutes). Drink the soup while it is warm.
Other ingredients can be added according to taste and tolerance,
e.g. grated carrots or pumpkin and finely chopped garlic.
6.3 Teas and drinks
To allow these teas and drinks to have the best effect on one’s
health, it is best to prepare them fresh three times a day and
drink them hot. If this is not possible, prepare them in the
morning and heat them before drinking. They can even be drunk
cold.
Cough syrup for adults
Indications: cold, cough.
Ingredients – lasts about 10 days: 1 fengal honey, 1 fengal
lemon juice, 1 fengal alcohol (zebib) or 1 garlic.
Preparation: Mix one part honey with one part lemon juice and
one part alcohol (zebib). Shake or stir well. Take one teaspoon
three times a day.
An alternative is to mix one part honey with one part lemon
juice. Add two finely chopped garlic cloves. Shake or stir well.
Take one teaspoon three times a day.
Cough syrup for children
Indications: cold, cough.
Ingredients – lasts about 10 days: 1 fengal honey, 1 fengal
lemon, 1 fengal water.
Preparation: Mix one part honey with one part lemon juice and
72
add one part water. Shake or stir well. Give children one
teaspoon three times a day. The syrup is best stored in a
refrigerator as it otherwise might ferment.
Energy drink
Indications: weight gain.
Ingredients – 1 serving: 1 large clove of garlic, ½ teaspoon
turmeric, fresh or grounded ginger, 1 cup of milk or water.
Preparation: Boil all the ingredients together. Simmer for ten
minutes. Cool slightly. Add a teaspoon of honey or sugar to
sweeten the drink if desired.
When having diarrhoea or difficulty digesting milk, replace the
milk with water.
Eucalyptus extract
Indications: herpes zoster, sore throat.
Ingredients: bunch of eucalyptus leaves, 1 bottle alcohol (40
percent proof).
Preparation: Fill a clean empty bottle with eucalyptus leaves.
Press them well down with a knitting needle or stick to pack in
as many leaves as possible. Fill up with alcohol. Press again to
release any air. Close the bottle. Leave in a dark place for two
weeks. Strain before using.
Use of the extract for sore throat: Put three drops of the extract on
the back of the tongue. This will disinfect the throat. Start using
the extract as soon as feeling a sore throat coming up. Continue
using the drops every two to three hours until no more pain is felt.
Garlic tea
Indications: cold, diarrhoea, thrush.
Ingredients – 1 serving: 3-4 cloves of garlic, honey, sugar, 1
73
cup water.
Preparation: Boil one cup of water. Chop 3-4 cloves of garlic.
Add to the boiling water. Boil together for ten minutes. Cover
and allow cooling. Add honey or sugar to taste. Drink one cup
three times a day.
Garlic and onion tea
Indications: sore throat.
Ingredients – 1 serving: 2-3 cloves garlic, ½ bulb onion, 1 cup
water.
Preparation: Chop 2-3 cloves of garlic and ½ bulb of onion. Put
the chopped garlic and onion into a cup of hot water. Allow the
water to simmer for ten minutes. Let the tea cool slightly before
drinking.
Ginger tea
Indications: nausea and vomiting.
Ingredients – 1 serving: 1 piece of dry ginger, 1 cup water.
Preparation: Crush one piece of medium sized ginger in cold
water and boil in water for ten minutes. Place in a covered
container, strain the ginger and drink three cups of the liquid per
day before meals.
Ginger and cinnamon tea
Indications: cold.
Ingredients – 1 serving: ½ teaspoon fresh ginger, ¼ teaspoon
cinnamon, 1 cup water.
Preparation: Add ½ teaspoon chopped fresh ginger to 1 cup of
boiling water. Boil slowly for ten minutes. Add ¼ teaspoon
ground cinnamon. Cover and allow standing for five minutes.
74
Strain. Drink one cup three times a day. Start drinking the tea as
soon as you feel the symptoms of a cold.
Guava tea
Indications: cold, fever.
Ingredients – 1 serving: 2 guava leaves, 2 tablespoons lemon
juice, eucalyptus leaves, 1 cup water.
Preparation: Add 2 guava leaves, a squeezed lemon, and a
eucalyptus leaf to 1 cup of boiling water. Cover and allow
standing for five minutes. Drink three times a day.
Immune strengthening combination drink
Indications: immune strengthening.
Ingredients – 1 serving: ¼ teaspoon cayenne pepper, 2
teaspoons lemon juice, 2 tablespoons aloe juice, 1 cup water.
Preparation: Mix ¼ teaspoon cayenne pepper, 2 teaspoons
lemon juice and 2 tablespoons aloe juice in 1 cup of boiled
water. Drink three times per day.
Lemon tea
Indications: cold, flu.
Ingredients – 1 serving: 2 teaspoons lemon juice, sugar or
honey, 1 cup water.
Preparation: Squeeze a lemon. Add the juice to ½ cup water
that has boiled and cooled slightly. Add sugar or honey to taste.
Drink one cup as hot as possible three times a day.
Neem tea
Indications: fever.
Ingredients – 1 serving: 1 fresh neem twig, 1 cup water.
75
Preparation: Cut a fresh twig from a neem tree. Remove the
leaves and boil the bark in water.
The bark can also be chewed.
Onion tea
Indications: cold.
Ingredients – 1 serving: ¼ onion bulb, 1 cup water.
Preparation: Put ¼ onion bulb into a cup of boiling water.
Cover and leave for five minutes. Strain. Throw the onion away.
Drink one cup three times a day.
Sour cabbage water
Indications: digestion problems.
Ingredients – 2 servings: 1 cup chopped raw cabbage, 3 cups water.
Preparation: Wash the cabbage and soak 1 cup cabbage in 3
cups water. Cover tightly and leave to stand for two to three
days. Strain the water from the cabbage, throw the cabbage
away and store the water in a cool place or refrigerator. It is
ready to drink when it starts to bubble (fermentation). Drink ½
cup three times a day for all digestive problems.
A second/following batch can be made by pouring ½ cup of the
first batch into the second batch, replacing some of the water,
and letting it stand for one day only.
Thyme extract
Indications: sore throat.
Ingredients – 1 serving: 20 gram dried thyme leaves, 100 ml
alcohol (40 percent proof).
76
Preparation: Use 20 g dried thyme leaves. Add 100 ml alcohol.
Keep in a closed bottle in a dark place for two weeks. Strain
before using.
Use of the extract for sore throat: Use three drops of the extract on
the back of the tongue. This will disinfect the throat. Start using the
extract as soon as feeling a sore throat emerging. Continue using
the drops every two to three hours until no more pain is felt.
Thyme tea
Indications: cold, sore throat, thrush.
Ingredients – 1 serving: ¼ teaspoon dried thyme leaves, water.
Preparation: Add ¼ teaspoon dried thyme leaves to 1 cup of
boiling water. Cover and leave for five minutes. Strain. Drink
one cup three times a day.
6.4 Snacks and other useful recipes
BP-5
Indications: weight gain.
Composition: wheat flour, hydrogenated oil, sugar, soya protein
concentrate, malt extract, minerals, amino acids, vitamins.
Ways to eat BP-5: it can be eaten as a bar straight from the
package, crumbled into water and eaten as porridge.
• To make porridge use 2 dl of boiled lukewarm drinking water
per food bar;
• If eaten dry, make sure drinking water is available.
Garlic ointment
Indications: herpes zoster.
Ingredients: 2 tablespoons crushed garlic, ½ cup Vaseline.
77
Preparation: Warm ½ cup of Vaseline, until it has melted.
Grind 2 tablespoons raw skinless pieces of garlic into a fine
paste. Add the garlic to the melted Vaseline and stir to mix well.
Take a clean glass jar. Place a metal spoon in the jar to stop the
heat from cracking the jar, and pour the mixture into the jar.
Place the lid on the jar. Store the ointment in a refrigerator or in
another cool place.
Pumpkin seeds
Indications: anaemia, cleans stomach/intestines.
Ingredients: Pumpkin seeds can be collected when using
pumpkin for other recipes.
Preparation: Place the seeds that still have the pulp around
them in a bowl of hot water. Separate the seeds from the pulp.
Dry the seeds in a warm place. Roast the seeds with the skin in a
menkeshkesh (or a pan) with a pinch of salt. The seeds can be
eaten with the skin.
Sibko
Indications: cold, constipation, diarrhoea, haemorrhoids, flu.
Ingredients – 1 serving: 1 fengal tihni, DMK or CSB, 5 fengal water.
Preparation: Boil 5 fengal of water in a pot; add 1 fengal of
tihni, DMK or CSB; keep stirring to avoid lump formation and
boil for ten minutes. Then add sugar, honey or butter. Serve hot.
Add sugar, honey or butter to taste.
Teteko
Indications: constipation, haemorrhoids, weight gain.
Ingredients – 3 servings: 2 cups kidney beans, 1 cup wheat, 5
cups water, ½ teaspoon salt.
78
Preparation: Wash the kidney beans and wheat first and then
put into a pot. Add the water and boil until they are well cooked.
Serve hot or cold.
Maize instead of the wheat and faba beans or chickpeas to
replace the kidney beans can also be used.
Kolo
Indications: constipation, haemorrhoids, weight gain.
Ingredients – 3 servings: 3 cups barley, 1 cup chickpeas.
Preparations: Roast the barley and chickpeas together in a
menkeshkesh. Serve hot or cold.
Wheat can be used instead of barley.
79
80
Endnotes
1. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 72.
2. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 84.
3. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 102.
4. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 102.
5. NZP+. 1995. Food for People Living with HIV/AIDS. page
30.
6. WHO/FAO. 2002. Living Well with HIV/AIDS: A Manual
on Nutritional Care and Support for People Living with
HIV/AIDS. page 37-38.
7. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 79-80.
8. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 81.
9. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 114-115.
10. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 83-84.
11 Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 86.
12. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 87.
13. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 88.
81
14. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 88.
15. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 62.
16. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 63.
17. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 63.
18. WHO/FAO. 2002. Living Well with HIV/AIDS: A Manual
on Nutritional Care and Support for People Living with
HIV AND AIDS. page 65-67.
19. Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 90.
20. FANTA Project. 2001. HIV/AIDS: A Guide for Nutrition,
Care and Support. page 30.
21 Orr & Patient. 2004. Positive Living – Train-The-Trainer
Manual. page 79.
22 FANTA Project. 2003. Nutrition and HIV/AIDS. A Training
Manual. Session 3. Powerpoint presentation slide 27.
23. WHO/FAO. 2002. Living Well with HIV/AIDS: A Manual
on Nutritional Care and Support for People Living with
HIV AND AIDS. page 87 - 88 .
24. WHO/FAO. 2002. Living Well with HIV/AIDS: A Manual
on Nutritional Care and Support for People Living with
HIV/AIDS. page 85-86.
25 WHO/FAO. 2002. Living Well with HIV/AIDS: A Manual on
Nutritional Care and Support for People Living with
HIV/AIDS. page 89.
82
ANNEXES
Good nutrition cannot cure AIDS or prevent HIV infection, but
it can help to maintain and improve the nutritional status of a
person with HIV and AIDS and delay the progression from HIV
to AIDS.
83
84
Annex 1 –
Cross reference tables of Eritrean recipes
and their respective usefulness
Recipe
Ailment/condition
Page
Adese (Timtimo)
Weight gain
63
Alicha with lentils
Weight gain
64
Alicha with vegetables
Haemorrhoids/constipation
Weight gain
64
Bean broth
Diarrhoea
65
Beans and tomatoes
Weight gain
64
BP 5
Weight gain
77
Bqulto
Anaemia
Haemorrhoids/constipation
Tuberculosis
91
Carrot and onion soup
Diarrhoea
70
Carrot soup
Diarrhoea
Sore mouth
Sore throat
Thrush
70
Combination drink
Immune strengthening
75
Cowpea paste
Herpes zoster
Tuberculosis
Weight gain
65
Energy drink
Weight gain
73
Eucalyptus extract
Herpes zoster
Sore throat
73
Garlic ointment
Herpes zoster
78
Garlic tea
Cold
Diarrhoea
Thrush
74
Garlic and onion tea
Sore throat
74
85
Page
Recipe
Ailment/condition
Ginger tea
Nausea and vomiting
74
Ginger and cinnamon tea
Cold
74
Green vegetables stew
Haemorrhoids/constipation
Weight gain
65
Guava tea
Cold
Fever
75
Hameli adegi (wild spinach)
Haemorrhoids/constipation
Herpes zoster
Tuberculosis
Weight gain
66
Helbet
Anaemia
Herpes zoster
Tuberculosis
Weight gain
66
Henbasha (Bekeo)
Weight gain
67
Injera
Weight gain
67
Kolo
Haemorrhoids/constipation
Weight gain
79
Lemon tea
Cold
Fever
Flu
75
Lentil or split peas soup
Herpes zoster
Weight gain
71
Minestrone
Diarrhoea
Sore throat
Thrush
68
Mixed beans with spinach
Weight gain
68
Neem tea
Fever
76
Onion tea
Cold
76
Pumpkin seeds
Anaemia
Clean stomach/intestine
78
86
Recipe
Ailment/condition
Page
Pumpkin soup
Diarrhoea
Sore mouth
Sore throat
Thrush
71
Pumpkin stew
Diarrhoea
Herpes zoster
69
Rice soup
Diarrhoea
Sore mouth
Sore throat
Thrush
71
Shiro
Weight gain
69
Sibko
Cold
Diarrhoea
Flu
Haemorrhoids/constipation
78
Sour cabbage water
Improve digestion
76
Teteko
Haemorrhoids/constipation
Weight gain
79
Tihni
Haemorrhoids/constipation
70
Thyme extract
Sore throat
77
Thyme tea
Cold
Sore throat
Thrush
77
87
Ailment/Condition
Recipe
Anemia
Bqulto
Helbet
Pumpkin seeds
91
66
78
Clean stomach/intestine
Pumpkin seeds
78
Cold
Sibko
Cough syrup for adults
Cough syrup for children
Garlic tea
Ginger and cinnamon tea
Guava tea
Lemon tea
Onion tea
Thyme tea
78
72
72
74
74
75
75
76
77
Cough
Cough syrup for adults
Cough syrup for children
72
72
Constipation
Alicha with vegetables
Bqulto
Green vegetables stew
Hameli adgi (wild spinach)
Kolo
Teteko
Tihni
64
91
65
66
79
79
70
Diarrhoea
Bean broth
Carrot and onion soup
Carrot soup
Garlic tea
Minestrone
Pumpkin soup
Pumpkin stew
Rice soup
Sibko
65
70
70
74
68
71
69
71
78
Fever
Guava tea
Lemon tea
Neem tea
75
75
76
88
Page
Ailment/Condition
Recipe
Flu
Lemon tea
Sibko
75
78
Hemorrhoids/constipation
Alicha with vegetables
Bqulto
Hameli adegi
Kolo
Sibko
Teteko
Tihni
64
91
66
79
78
79
70
Herpes zoster
Cowpea paste
Eucalyptus extract
Garlic ointment
Hameli adgi (wild spinach)
Helbet
Lentil or split pea soup
Pumpkin stew
65
73
78
66
66
71
69
Immune strengthening
Combination drink
75
Improve digestion
Sour cabbage water
76
Nausea and vomiting
Ginger tea
74
Sore mouth
Carrot soup
Pumpkin soup
Rice soup
70
71
71
Sore throat
Carrot soup
Thyme tea
70
71
73
74
68
71
77
77
Carrot soup
Pumpkin soup
Rice soup
70
71
71
Pumpkin soup
Eucalyptus extract
Garlic and onion tea
Minestrone
Rice soup
Thyme extract
Thrush/Candida
Page
89
Ailment/Condition
Recipe
Page
Garlic tea
Minestrone
74
Tuberculosis
Alicha with vegetables
Alicha with lentils
Bqulto
Cowpea paste
Hameli adegi,
Helbet
64
64
91
65
66
66
Thrush/Candida
Thyme tea
77
Weight gain
Adese (Timtimo)
Alicha with lentils
Alicha with vegetables
Beans and tomatoes
BP 5
Cowpea paste
Energy drink
Green vegetables stew
Hameli adgi (wild spinach)
Helbet
Henbasha (Bekeo)
Injera
Kolo
Lentil or split peas soup
63
64
64
64
77
65
73
65
66
66
67
67
79
71
90
68
Annex 2 –
Ways to sprout grains for eating
Sprouts are actually grains that are starting to grow into a new
plant. Sprouted grains have a number of advantages over the
grain itself.
Advantages of sprouted food
• Sprouting increases the vitamin, mineral and protein content;
• Sprouted food contains many live enzymes that can help the
food to be digested more easily;
• Sprouting helps to cut down on the cooking time;
• Sprouting is an easy and cheap way to obtain fresh food.
Method for sprouting food
1. Put the amount of seeds shown in the chart on the next page
in a jar.
2. Fill the jar half full with clean and safe water.
3. Use a tight rubber band to secure a cheesecloth or mesh over
the jar.
4. Soak seeds overnight (or as shown in the chart).
5. Drain the water.
6. Put the jar down at an angle so that the water can drain off (a
dish rack is perfect for this).
7. Keep the jar in the dark until sprouting begins.
8. Rinse the sprouts to remove the shells twice a day – use clean
and safe water –, morning and evening. If it is very hot, rinse
more often.
9. Place in a cool place or refrigerator as the seeds are now
ready to eat.
10. Eat the sprouts after the length of time shown in the chart on
the next page.
One can try to make different kinds of sprouts from seeds such
as alfalfa, beans, lentils, peas, sorghum and sunflower. Since
they need a different length of time to grow, they cannot be put
91
in the same jar. All sprouts can be eaten raw – after careful
washing with clean water – in salads, sandwiches and, for
example, in scrambled eggs. They can also be cooked in stews
and soups.
Attentions should be paid to the source of the seeds as
sometimes the treatments used to preserve the seeds – e.g.
fumigation – may seriously reduce their capacity to germinate.
Sprouting chart
Type of
grain
Amount of
grains per
jar
Time to
soak the
grains
Approximate
time until
ready to eat
Length of
sprout when
ready to eat
Alfalfa
3-4 tablespoons
4 hours
4-6 days or until
seeds develop
green leaves
3 cm
Beans
(bqulto)
1 cup
Overnight
4-7 days
1 cm
Groundnuts/
peanuts
(whole)
1 cup
Overnight
1-2 days
Swell, do not
sprout
Lentils
1 cup
Overnight
2-5 days
1/2-1 cm
Maize
1 cup
Overnight
3-4 days
1 cm
Peas
1 cup
Overnight
2-5 days
1 cm
Sorghum or
millet
1 cup
Overnight
2-3 days
1/2 cm
Sunflower
(without
husks)
1 cup
Overnight
1-3 days
1/2-1 cm
92
Annex 3 – Recommended
Daily Allowances (RDA)
for an adult person or child older than
four years living with HIV and AIDS19
Nutrient
Daily required Daily required Example of food
HIV- person
HIV+ person providing RDA
10-15% more
• 1 cup teheni -ORenergy per day • ¼ injera with 2
(about 400 kcal
chelefa tsebehi
for men and 300 lentils -ORkcal for women) • 200 g porridge
with 3 tablespoons
of butter
About 50 –
57 g/day for
Protein
• 1 kg DMK -OR100% more
men
• ½ kg chickpeas
protein/day (85
48 g/day for
(kolo) -ORg for men; 72 g • or 4 chelfa shiro
women
for women)
50,000 IU
Beta-carotene 25,000 IU
• 1½ medium raw
(15 mg)
(30 mg)
(vitamin A)
carrot -OR• 3 mangoes
60 mg
120 – 250 mg
Vitamin C
• 3 oranges
-OR• 2 guavas
Vitamin B 12 10 mcg (micro- 20 mcg
• 30 g liver
gram)
-OR• 75 g tinned sardines
75 to 200 mcg
Selenium
• 100 ml aloe juice
-OR• 12 small sardines
10 – 12 mg
15 – 45 mg
Zinc
• 2½ cups boiled
wild spinach -OR• 1½ cups pumpkin
seeds
• 3 cups peanuts
Energy
1500 – 2100
kcal/day
93
Annex 4 –
Suggested
vitamin
and
mineral
supplement or people living with HIV and
AIDS20
Vitamin A
13,000-20,000 IU (International Units)
Vitamin E
400-800 IU
Vitamin B
High-potency B complex (e.g., B-25 or
B-50 with niacin and B6)
Vitamin C
1,500-2,000 milligram (mg)
Selenium
200 microgram (µg)
Zinc
12-19 mg
Note: The amounts given above are for daily intake of food and
supplements combined.
The vitamins and minerals in pills work best when taken without
any food in the stomach. Should this cause pain or discomfort,
the pills can also be taken together with some food. One can also
try taking a pill just before bedtime. Do not forget however to
read the specifications enclosed in the packaging of vitamin and
mineral supplement pills.
It is possible to take excessive amounts of vitamins and minerals
through the intake of supplement pills. Therefore annex 6, which
mentions the adverse effects of excessive intakes, can be referred
to.
94
Annex 5 –
Foods rich in selenium21
Type of food
Weight (in grams) Selenium
or quantity
Canned sardine in oil
100 gram
Sunflower seeds
1 cup
86 µg
Chicken meat
(¼ roasted)
Beef meat (cooked)
100 to 120 gram
24 µg
100 gram
17 µg
Goat meat
100 gram
12 µg
Eggs
100 gram
15 µg
Peanut (dry roasted)
150 gram (1 cup)
11 µg
Rice
1 cup
10 µg
Pumpkin seeds
140 gram (1 cup)
52.7 µg
8 µg
95
Annex 6 –
Possible adverse effects of excessive
intake of nutrient supplements22
Intake of too many vitamins and minerals can be harmful. When
taking supplements under the form of pills, it is very important
to follow the instructions on the label.
Nutrient
Possible adverse effect of excessive intake
Vitamin B
Gastrointestinal upsets.
Vitamin C
Gastrointestinal upsets, iron over absorption
and abdominal bloating.
Vitamin E
Malabsorption of vitamins A and K and
gastrointestinal upsets.
Iron
Gastrointestinal bleeding (manifested by
vomiting and bloody diarrhoea) and possible
stimulation of viral replication.
Selenium
Skin lesions, nausea and vomiting.
Zinc
Gastric distress, nausea, reduced immune
function that favours viral replication.
96
Annex 7 –
Role and food source of selected micronutrients23
MINERALS
Micronutrient
Role
Iron
Essential for transport of
oxygen by blood; eliminates
old red blood cells, and
builds new cells.
Calcium
Zinc
Iodine
Magnesium
Selenium
Food source
Red meat, poultry,
shellfish, eggs, peanuts,
groundnuts, lentils,
beans, some cereals,
dried fruit.
Builds strong bones and
Milk, green leafy
teeth; important for the
vegetables, shrimp, dried
functioning of the heart and fish, beans, lentils, peas,
muscles, blood clotting and whole-grain millet, oil
pressure; immune defences. seeds, okra.
Reinforces immune system; Wild spinach, fish,
facilitates digestion;
peanuts, chicken, meat,
transports vitamin A.
cereals, vegetables.
Ensures development and
Fish and other seafood,
proper functioning of brain iodized salt.
and nervous system.
Strengthens muscles;
Cereal, dark green
important for nervous system vegetables, seafood, nuts,
functions, involved in bone peanuts, legumes.
development and
maintenance of teeth.
Acts as antioxidant together The inner white flesh of
aloe leaves, sea fish, sun
with vitamin E and fights
HIV, prevents the impairing flower seeds, meat, eggs,
chicken, peanuts, rice,
of heart muscle.
pumpkin seeds.
97
VITAMINS
Micronutrient
Role
Vitamin A
(Beta-carotene)
Growth and function of T and Liver and dairy products,
B cells of immunity system; dark green leafy
maintenance of specific cells, vegetables, kidneys, eggs,
including lining of respiratory some fishes, sweet
and gastrointestinal tracts.
potatoes, pumpkin, palm
Vitamin A deficiency is
oil, carrots, fruits such as
associated with increased HIV ripe papaya.
progression, increased adult
mortality, increased mother-tochild transmission, higher
infant mortality and child
growth failure.
Important for energy
Whole-grain cereals,
metabolism; supports appetite beans, meat, fish, chicken,
and nervous system functions. eggs.
Important for energy
Milk, yoghurt, meat, green
metabolism; supports normal leafy vegetables, wholevision, and the health and
grain cereals, fish, beans.
integrity of skin.
Milk, eggs, poultry,
Essential for energy
metabolism; supports integrity peanuts, groundnuts,
and health of skin, and the
whole-grain cereals, fish.
nervous and digestive systems.
Facilitates metabolism and
Sweet potatoes, white
absorption of fats and protein; beans, maize, meat,
has a role in the productions of avocados, cabbage, fish.
red blood cells.
Important for development of Red meat, fish, chicken,
new cell and maintenance of shellfish, cheese, eggs,
the nerve cells.
milk, fermented products.
Important for the immune
Oranges, guava, tomatoes.
functions and iron absorption.
Protects cell structures and
Leafy vegetables, vegetable
makes it easier to resist disease. oils, egg yolk, peanuts, liver.
Vitamin B1
(Thiamine)
Vitamin B2
(Riboflavin)
Vitamin B3
(Niacin)
Vitamin B6
(Pyridoxine)
Vitamin B12
(Cobalamin)
Vitamin C
(Ascorbic acid)
Vitamin E
98
Food source
Annex 8 –
Form to monitor food intake over one
week24
This form can help in monitoring a person’s food intake. It
should be filled in carefully every day, noting the amount eaten
every time. The form can then be reviewed and discuss with a
nutritionist or doctor at the end of one or two weeks. Compare
the sheets from week to week can help to see whether a person
is eating less from one week to another. It will also help to see
whether the food intake gradually goes down, even if this is not
felt by the person. In the case a decrease in taking place, the
reason(s) should be identified (e.g. diarrhoea, sore mouth,
feeling weak) and the guidelines provided followed to increase
the food intake.
Example of how to fill in the form
Meal
Date
Monday
19/09
Breakfast
7am
Snack
10am
Lunch
1pm
Snack
4pm
Supper
8pm
Bread +
tea
1 cake
Injera with
shiro
bread with
tea
Injera with
hameli adgi
sauce
Tuesday
20/09
Porridge
with butter
Kicha
Rice with
fish
Kicha with
tea
Porridge
with butter
Wednesday
21/09
Tihni with
tea
1 bread
Injera with
temtemo
1 cup peanut
Injera with
alicha
Thursday
22/09
Sibko
Kicha
porridge
with butter
1cup teteko
Injera with
hameli adgi
Friday
23/09
Kicha with
tea
Teheni
Pasta with
sauce
Pumpkin
seeds
Pasta with
sauce
Saturday
24/09
Bread
1 cake
Rice with
fish
1 cup Bekelto
Injera with
meat sauce
99
Annex 9 – Form
to monitor weight changes over
25
time
Each time a patient/person weighed, the weight is written on the
form. Since sometimes-different scales may be used, this could
explain some of the weight variations. The person should be
weighed without shoes and each time in similar clothes. Under
the remarks header, causes of changes in eating habits and other
reasons, which could explain the weight changes, can be noted.
Example of how to fill in the form
Date
Where
Weight Remarks (diarrhoea, fever, food
(kg) shortage, etc.)
20/08
Pharmacy
65
Normal
10/09
Pharmacy
62
Because of diarrhoea
12/10
Pharmacy
64
Normal
100
___/___/___
Sunday
___/___/___
Saturday
___/___/___
Friday
___/___/___
Thursday
___/___/___
Wednesday
___/___/___
Tuesday
___/___/___
Monday
___/___/___
Sunday
___/___/___
Saturday
___/___/___
Friday
___/___/___
Thursday
___/___/___
Wednesday
___/___/___
Tuesday
___/___/___
Monday
Date
Meal
Breakfast
Snack
Lunch
Snack
Form to monitor food intake over two week
Supper
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
----/----/----
Date
Where
Remarks
(diarrhoea, fever, food shortage, etc.)
Weight
(kg)
Form to monitor weight changes over time
Annex 10 – Bibliography and sources
Boyle, Marie A. and Diane H. Morris, 2003. Community
Nutrition in Action, and Entrepreneurial Approach, 3rd Edition.
Wadsworth, Publishing Company, Belmont, CA, USA.
Bijlsma, M. 1997. Living positively: a nutrition guide for
people with HIV/AIDS. Second ed. Mutare City Health
Department, Box 910, Mutare, Zimbabwe.
FANTA Project. 2001. HIV/AIDS: a guide for nutrition, care
and support. Food and Nutrition Technical Assistance Project,
Academy for Educational Development. Washington DC, USA.
www.fantaproject.org
FANTA Project. 2003. Nutrition and HIV/AIDS. A Training
Manual. Regional Centre for Quality of Health Care (RCQHC)
and Food and Nutrition Techincal Assistance Project, Kampala,
Uganda. www.fantaproject.org
NAP+. 1996. Food for people living with HIV/AIDS. Network
of African People Living with HIV/AIDS Pretoria, South
Africa, Hope Productions. NAP+ Secretariat, PO Box 30218,
Nairobi, Kenya.
NAP+. Undated. A healthy diet for better nutrition for people
living with HIV/AIDS. Network of African People Living with
HIV/AIDS Secretariat, PO Box 30218, Nairobi, Kenya.
NPZ+. 1995. Food for people living with HIV/AIDS. Network of
Zambian People Living with HIV/AIDS. Capetown, South
Africa, Hope Productions. NZP+ Secretariat, PO Box 32717,
Lusaka, Zambia.
MoH Uganda 2004. Nutritional Care and Support for People
Living With HIV/AIDS in Uganda. Ministry of Health/Food and
Nutrition Technical Assistance Project (FANTA), Kampala,
Uganda.
103
Orr, Neil M and Patient, David R. 2004. Positive Living
Train-The-Trainer Manual. Empowerment Concepts CC.
Nelspruit 1200, Republic of South Africa.
WHO/FAO. 2002. Living well with HIV AND AIDS: a manual
on nutritional care and support for people living with HIV AND
AIDS. FAO, Rome, Italy.
104
Annex 11 – Glossary
Absorption
The process whereby nutrients from the food pass into the blood
stream for use by the body.
AIDS
Acquired Immunodeficiency Syndrome: a group of diseases
caused by HIV.
ARV
Antiretroviral: the name given to a group of drugs that act on the
HIV virus and prevent it from reproducing itself in the body.
Candida
The name of a fungus that causes oral thrush, an infection of the
mouth. Infection can also happen in other body parts, such as
vagina and anus.
Constipation
A condition when the bowels, intestines, are not functioning
properly and a person has difficulty in passing stools,
defecating. This may be caused by a diet low in fibre, it can be a
symptom of illness, or a side effect of medicines.
Carbohydrates
A group of nutrients composed of starch, glucose and other
sugars. They are normally the body’s main source of energy.
Dehydration
The excessive loss of water and salts by the body. This often
happens during a case of diarrhoea.
Diarrhoea
The frequent passing of watery faeces (stools); at least three in a
day.
Digestion
The process in the stomach and intestine in which food is broken
105
down and nutrients are released.
Fetfet
A traditional Eritrean dish of bread or injera cut into pieces and
mixed with yoghurt or stew.
Healthy and balanced diet
A diet is healthy and balanced when there is consumption of an
adequate amount and variety of foods as appropriate, sufficient
to meet one's energy and nutrient needs. This includes staples,
legumes, animal products, fruit, vegetables, nuts, fat and oils,
and sugar/sugar-containing foods.
HIV
Human Immunodeficiency Virus: a viral infection which affects
the immune system and can lead to AIDS.
Immune system
All the body’s mechanisms that defend the body against external
agents, particularly microbes such as viruses, bacteria, fungi and
parasites.
Kolo
An Eritrean traditional snack, prepared on special occasions. It
is a roasted product prepared from either cereals (e.g. barley,
corn or wheat), legumes (e.g. chickpeas) or from a combination
of cereals and legumes.
Melesi
An Eritrean kind of bowl used to ferment the batter for making
injera.
Menkeshkesh
An Eritrean traditional – pan shaped – utensil used to roast
coffee, kolo, pumpkin seeds and popcorn.
Mineral
Nutrients that are required in small amounts by the body, but are
nevertheless essential. They have a role in protecting the body
from infections.
106
Malnutrition
An abnormal physiological condition caused by deficiencies,
excesses or imbalances in the nutrient intake of the body, e.g.
energy, protein and/or other nutrients. In this guidebook the
term malnutrition is only used for the case of lack of food
energy (i.e. under nutrition) and the case of lack of nutrients.
Nausea
The state of feeling unwell or sick in the stomach.
Nutrient
Nourishing substance contained in foods that is released during
digestion. This includes carbohydrates, proteins, fats, minerals
and vitamins.
Nutrition
The science of food and how it is used by human – and animal –
bodies to grow, work, play, maintain health and resist disease.
Opportunistic infection
An infection by a micro-organism that does not ordinarily cause
disease. In the case of a person whose immune system is
weakened, such as by HIV infection, this micro-organism may
become pathogenic and result in disease.
Oral Rehydration Salts (ORS)
A liquid that can be given to people to restore the fluid that they
have lost through diarrhoea. ORS can be made from packets, by
mixing salt, sugar and water or by making a watery porridge
from powdered cereals such as rice and maize.
Protein
Proteins are nutrients that provide the building materials for the
body. They are also an essential element of the immune system.
Pulses
The edible seeds of various leguminous plants, e.g. chickpeas,
lentils, beans, etc.
107
Refined cereals
Cereals like wheat, rice or maize, that have been extensively
processed, removing all or part of the bran. They are low in fibre.
Ritonavir
Ritonavir is an anti-retroviral drug.
Saquinavir
Saquinavir is an anti-retroviral drug.
Staple foods
Foods that form the main part of the diet, usually cereals such as
maize, sorghum, wheat and millet, eaten in Eritrea under the
form of injera, kicha, haneza and porridge.
Tsebhi
A Tigrinya term for stew. It is often used in combination with
the name of a spice/food to typify the type of stew, for example
tsebhi shiro, tsebhi alicha, tsebhi adese.
Virus
Infectious agent (microbe) responsible for many diseases in all
kinds of living beings. It is an extremely small particle and, in
contrast with bacteria, can only survive and multiply within a
living cell at the expense of that cell.
Vitamins
A group of nutrients needed in small amounts – micronutrients –
by the body for it to function normally. An insufficient intake of
vitamins can result in some serious disturbances in the body’s
functioning and ultimately disease. Vitamins occur naturally in
food.
108
Ministry of Health
of the State of Eritrea
WFP
United Nations
World Food Programme
Eritrea
Food and Agriculture Organization
of the United Nations
Eritrea
World Health Organization
Eritrea
Joint United Nations
Programme on HIV and AIDS
Eritrea